A biological conservative approach to complex traumatic dento-alveolar lesions

Of all the kinds of traumatic dental injury, luxation injuries associated with crown-root fractures deserve special attention due to the particular need for complex multidisciplinary treatment. Clinical experience has demonstrated the need for repositioning of luxated teeth and treatment of crown-root fractures by orthodontic or surgical extrusion and completed with periodontal plastic surgery (gingivoplasty). In many cases the outcome is good conservation and excellent esthetic results. This approach cannot however, always be recommended, for example because of the age of the patient. For this reason, a different protocol is proposed that involves, in addition to orthodontic repositioning of the luxated teeth, (as is required to return teeth to the physiological position), the extrusion, restoration and subsequent re-intrusion to the natural position (without the need for further surgery) of those teeth involved with associated crown-root fractures. Two cases illustrate the use of this proposed technique. J Clin Pediatr Dent 28(1): 1-10, 2003

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